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Liu T, Huang L, Liu J, Zhang Y. Liver vein deprivation combined with two-step hepatectomy for the treatment of advanced hepatic alveolar echinococcosis with remnant liver volume deficiency. Asian J Surg 2024; 47:2397-2398. [PMID: 38365566 DOI: 10.1016/j.asjsur.2024.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024] Open
Affiliation(s)
- Tao Liu
- Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Liang Huang
- Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Liu
- Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yu Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
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Reyimu A, Tiemin J, Yingmei S, Xuepeng Z, Wenjiang G, Yuhao D, Halimulati D, Ababokeli W, Tuerganaili A, Hao W. Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo Liver Resection and Autotransplantation. Ann Transplant 2024; 29:e942358. [PMID: 38622855 PMCID: PMC11032082 DOI: 10.12659/aot.942358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/19/2023] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Hepatic cystic echinococcosis (HCE) is a frequently overlooked parasitic liver disease, for which the commonly recommended treatment is radical resection. However, this approach is often associated with severe comorbidities such as HBV/HCV, cirrhosis, and hepatic carcinoma, among others. CASE REPORT In this report, we present a case successfully managed by ex vivo liver resection and autologous liver transplantation (ELRA). In the described case, ex vivo resection was not feasible due to recurrent lesions and infections invading the portal vein, which resulted in portal vein cavernous transformation. CONCLUSIONS Through this paper, we aim to detail the treatment process, showcasing the feasibility and advantages of ELRA. Additionally, we propose a novel approach for the treatment of this disease, while emphasizing the importance of radical resection surgery to prevent long-term complications.
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Affiliation(s)
- Ayidu Reyimu
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Jiang Tiemin
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Shao Yingmei
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Zhu Xuepeng
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Guo Wenjiang
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Du Yuhao
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Dilixiati Halimulati
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Wusiman Ababokeli
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Bayingolin Mongol Autonomous Prefecture, Korla, Xinjiang, PR China
| | - Aji Tuerganaili
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
| | - Wen Hao
- Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China
- State Key Laboratory of Pathogenesis, Prevention and Management of High-Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, Xinjiang, PR China
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Trigui A, Toumi N, Fendri S, Saumtally MS, Zribi I, Akrout A, Mzali R, Ketata S, Dziri C, Amar MB, Boujelbene S. Cystic Echinococcosis of the Liver: Correlation Between Intra-Operative Ultrasound and Pre-Operative Imaging. Surg Infect (Larchmt) 2024; 25:213-220. [PMID: 38483340 DOI: 10.1089/sur.2023.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Background: Imaging plays an essential role in the management of hepatic hydatid cysts (HCE). The objective of our study was to determine the correlation between pre-operative ultrasound, computed tomography (CT), and intra-operative ultrasound (IOUS) in studying the characteristics and complications of HCE. Patients and Methods: This was a prospective, descriptive, and analytical study conducted in the General Surgery Department of Habib Bourguiba Hospital in Sfax. The study included patients with HCE who underwent conservative surgery between April 2017 and June 2022. Results: We enrolled 49 patients with 94 cysts. At the end of our study, IOUS allowed for better detection of HCE (98.8%) regardless of the number of cysts per patient. IOUS and CT were accurate in studying the location of cysts (κ = 1), whereas pre-operative abdominal ultrasound was less efficient (κ = 0.870). IOUS was the best examination for detecting exocysts (κ = 0.961), studying daughter cysts (κ = 0.823), and exploring vascular relations, but it was less effective (κ = 0.523) in detecting calcifications. Regarding classifications, ultrasound and CT had similar results. However, IOUS was most reliable in differentiating between CE3b and CE4 types (κ = 0.653). Ultrasound, CT, and IOUS were not sensitive in detecting latent HCE suppurations and cystobiliary fistulas. Conclusions: Performing IOUS is essential to prevent recurrences and reduce post-operative morbidity.
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Affiliation(s)
- Aymen Trigui
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Nozha Toumi
- Department of Radiology, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Sami Fendri
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mohammad Saad Saumtally
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Imen Zribi
- Department of General and Digestive Surgery, Hopital Regional Mahres, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Amira Akrout
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Rafik Mzali
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Salma Ketata
- Department of Anesthesiology, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Chadli Dziri
- University of Tunis El Manar, General Surgery; Honoris Medical Simulation Center, Tunisia
| | - Mohamed Ben Amar
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Salah Boujelbene
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
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Guo Q, Wang ML, Zhong K, Li JL, Jiang TM, Wen H, Aji T, Shao YM. Portal vein embolization combined with ex vivo liver resection and autotransplantation: A novel treatment strategy for end-stage and metastatic hepatic alveolar echinococcosis. Hepatobiliary Pancreat Dis Int 2024; 23:210-216. [PMID: 37295974 DOI: 10.1016/j.hbpd.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Qiang Guo
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Mao-Lin Wang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Kai Zhong
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Jia-Long Li
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Tie-Min Jiang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Hao Wen
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi 830054, China
| | - Tuerganaili Aji
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Ying-Mei Shao
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi 830054, China.
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Yilmaz L, Bulut A, Aytekin A, Baskonus I, Yildiz F, Coban S, Balik AA. A Novel Technique for the Management of Persistent Biliary Fistulas Developing After Liver Hydatid Cyst Surgeries: Drain Clamping Technique. Dig Dis Sci 2024; 69:961-968. [PMID: 38340259 DOI: 10.1007/s10620-024-08284-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 01/05/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND External biliary fistula, where the residual cyst is associated with the biliary tree, is one of the most common complications after liver hydatid cyst surgery. Surgical procedures become a consideration for patients in whom the biliary fistula persists despite all endoscopic procedures. However, reoperation for biliary fistula after hydatid cyst surgery leads to additional complications and increases morbidity and mortality. AIM This study aims to treat persistent biliary fistulas that develop after liver hydatid cyst surgery using a simple noninvasive technique. MATERIALS AND METHODS External drainage surgery was performed on 295 patients with liver hydatid cysts. Endoscopic treatment methods were used in patients who developed biliary fistula after surgery. Despite all endoscopic treatment methods, 14 patients developed persistent biliary fistulas. These patients were subsequently treated using the drain clamping technique. FINDINGS All persistent fistulas occluded in 11.86 days (with a range of 8-20 days). No complications were observed in the one-year follow-up visits. CONCLUSION Drain clamping, a novel approach to the treatment of persistent biliary fistulas developed despite all available endoscopic methods, can be safely used. This technique resulted in a complete recovery in patients without the need for surgical procedures.
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Affiliation(s)
- Latif Yilmaz
- Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey.
| | - Aziz Bulut
- Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Alper Aytekin
- Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ilyas Baskonus
- Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Fahrettin Yildiz
- Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sacid Coban
- Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ahmet A Balik
- Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
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Manterola C, Rivadeneira J, Rojas-Pincheira C, Otzen T, Delgado H, Sotelo C, Sanhueza A. Cholangiohydatidosis. Clinical features, postoperative complications and hospital mortality. A systematic review. PLoS Negl Trop Dis 2024; 18:e0011558. [PMID: 38452054 PMCID: PMC10950226 DOI: 10.1371/journal.pntd.0011558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 03/19/2024] [Accepted: 02/14/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Cholangiohydatidosis (CH) is an evolutionary complication of hepatic cystic echinococcosis, associated with increased morbidity and mortality. The aim of this study was to describe the available evidence regarding clinical characteristics of CH, postoperative complications and hospital mortality. METHODOLOGY/PRINCIPAL FINDINGS Systematic review. Studies related to CH with no language or publication restriction were included. Sensitive searches were performed in Trip Database, SciELO, BIREME-BVS, WoS, PubMed, EMBASE and SCOPUS. MeSH and free terms were used, including articles up to April 2023. The main outcome variables were postoperative complications and hospital mortality; the secondary ones were publication year, origin and design of primary studies, main clinical manifestation, anatomical location and type of cysts, hospital stay, surgical procedure performed, reinterventions; and methodological quality of primary studies, which was assessed using MInCir-T and MInCir-P scales. Descriptive statistics, calculation of weighted averages and their comparison by least squares logistic regression were applied. 446 studies were retrieved from the searches performed, 102 of which met the inclusion and exclusion criteria. The studies analyzed represent 1241 patients. The highest proportion of articles was published in the last decade (39.2%). Reports are mainly from Turkey (28.4%), Greece (9.8%), Morocco and Spain (8.8% each). With a weighted mean of 14.3 days of hospital stance; it was verified that 26.2% of patients developed postoperative complications (74,3% Clavien y Dindo III y IV), 6.7% needed re-interventions, and 3.7% died. When comparing the variables age, postoperative complications, hospital mortality, and reinterventions in two periods of time (1982-2006 vs. 2007-2023), no statistically significant differences were found. When applying the MInCir-T and MInCir-P scales, the methodological quality of the primary studies was 9.6±1.1 and 14.5±4.3 points, respectively. CONCLUSION/SIGNIFICANCE CH is associated with severe postoperative complications and significant hospital mortality, independent of the development of therapeutic support associated with the passage of time.
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Affiliation(s)
- Carlos Manterola
- Center for Morphological and Surgical Studies. Universidad de La Frontera. Chile
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Josue Rivadeneira
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
- Zero Biomedical Research. Quito, Ecuador
| | - Claudio Rojas-Pincheira
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Tamara Otzen
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Hugo Delgado
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
| | | | - Antonio Sanhueza
- Pan American Health Organization, Washington, United States of America
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7
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Li YP, Zhang J, Li ZD, Ma C, Tian GL, Meng Y, Chen X, Ma ZG. Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China. World J Gastroenterol 2024; 30:462-470. [PMID: 38414590 PMCID: PMC10895592 DOI: 10.3748/wjg.v30.i5.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Some hydatid cysts of cystic echinococcosis type 1 (CE1) lack well-defined cyst walls or distinctive endocysts, making them difficult to differentiate from simple hepatic cysts. AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries. METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region (China) from January 2018 to September 2023 were retrospectively analyzed. Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis, routine abdominal ultrasound, high-frequency ultrasound, abdominal computed tomography (CT) scan, and laparoscopy. Subsequent to the treatments, these patients underwent reexaminations at the outpatient clinic until October 2023. The evaluations included the diagnostic precision of diverse examinations, the efficacy of surgical approaches, and the incidence of CE recurrence. RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan. Among them, 16 patients were preoperatively diagnosed with atypical CE1, and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound. All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy, of whom 14 patients were intraoperatively confirmed to have CE1, which was consistent with the postoperative pathological diagnosis, one patient was diagnosed with a mesothelial cyst of the liver, and the other was diagnosed with a hepatic cyst combined with local infection. Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts, 4 received aspiration sclerotherapy of hepatic cysts, and 19 received laparoscopic fenestration. These patients were intraoperatively diagnosed with simple hepatic cysts. During the follow-up period, none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices. One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space. CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts. The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.
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Affiliation(s)
- Yu-Peng Li
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Jie Zhang
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Zhi-De Li
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Chao Ma
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Guang-Lei Tian
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Yuan Meng
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Xiong Chen
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Zhi-Gang Ma
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
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Öter S, Yalçın M. RE: What Is the Optimal Treatment for Liver Hydatid Cysts in Emergency and Elective Situations? Turk J Gastroenterol 2024; 35:160. [PMID: 38454249 PMCID: PMC10895873 DOI: 10.5152/tjg.2024.235342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Serdar Öter
- Department of Gastroenterological Surgery, Manisa City Hospital, Manisa, Turkey
| | - Metin Yalçın
- Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
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Wang Z, Yu W, Zhou L, Kong F, Qi M, Ren B, Yangdan C, Zhang L, Wang H, Fan H, Ren L. Comparison of treatment efficiency of percutaneous transhepatic biliary drainage and endoscopic retrograde cholangiopancreatography for non-surgical hepatic alveolar echinococcosis patients suffered from jaundice: exploration from a single center. Minerva Surg 2024; 79:121-123. [PMID: 35088996 DOI: 10.23736/s2724-5691.21.09397-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Zhixin Wang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Wenhao Yu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Liuxin Zhou
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Fanyu Kong
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Mengjian Qi
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Bin Ren
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Cairang Yangdan
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Lingqiang Zhang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Haijiu Wang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Haining Fan
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
| | - Li Ren
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China -
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10
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Trigui A, Fendri S, Akrout A, Trabelsi J, Daoud R, Saumtally MS, Ketata S, Baklouti S, Boujelbene W, Mzali R, Dziri C, Rejab H, Boujelbene S. Predictive factors of occult cystobiliary fistulas during conservative treatment of hepatic hydatid cyst: a prospective study. J Gastrointest Surg 2024; 28:108-114. [PMID: 38445931 DOI: 10.1016/j.gassur.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/04/2023] [Accepted: 10/14/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Occult cystobiliary fistula (CBF) is a common complication of hepatic hydatid cyst (HHC). It is often the cause of high morbidity of conservative treatment of HHC. This study aimed to determine the predictive factors of occult CBF to establish the indications for the investigation and treatment of these CBFs. METHODS This was a prospective study that included all operated HHCs over a 3-year period. HHCs complicated with large CBFs were not included in the study. Systematic cholecystectomy and methylene blue test for all cysts were performed. RESULTS A total of 46 patients operated on with 113 cysts were included in this study. The median cyst size was 6.7 cm (IQR, 1-38). A total of 114 CBFs were detected in 51 cysts (45.1%). The postoperative course was simple in 95.0% of cases. The specific morbidity rate was 2.7%. In a bivariate study, absence of mass and abdominal pain on palpation, hemoglobin level >11.55 g/dL, negative hydatid serology, cyst size, absence of calcifications, vascular compression, existence of a single cyst, and localization at segment VIII were predictive factors of occult CBF. At the end of the multivariate study, cyst size was determined to be the only predictive factor for occult CBF. A threshold of 3 cm was used. CONCLUSION Cyst size is a major predictive factor for occult CBF.
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Affiliation(s)
- Aymen Trigui
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia.
| | - Sami Fendri
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Amira Akrout
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Jihen Trabelsi
- Department of Epidemiology, Faculty of Medicine, Hedi Cheker Hospital, University of Sfax, Sfax, Tunisia
| | - Rahma Daoud
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Mohamed Saad Saumtally
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Salma Ketata
- Department of Anesthesiology, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Soulaymen Baklouti
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Wael Boujelbene
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Rafik Mzali
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Chadli Dziri
- Department of General Surgery, Medical School of Tunis, University of Tunis El Manar, Tunis, Tunisia; Honoris Medical Simulation Center, Tunis, Tunisia
| | - Haithem Rejab
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Salah Boujelbene
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
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Gloor S, Jiang W, Maurer MH, Gottstein B, Oberli A, Hagemann JB, Hotz JF, Candinas D, Lachenmayer A, Grüner B, Beldi G. The trajectory of anti-recEm18 antibody levels determines follow-up after curative resection of hepatic alveolar echinococcosis. HPB (Oxford) 2024; 26:224-233. [PMID: 37867084 DOI: 10.1016/j.hpb.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/15/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Recurrence after curative resection of hepatic alveolar echinococcosis remains a clinical challenge. The current study tested if assessment of anti-recEm18 allows for postsurgical patient surveillance. METHODS A retrospective study with patients undergoing liver resection for alveolar echinococcosis (n = 88) at the University Hospital Bern from 2002 to 2020 and at the University Hospital and Medical Center Ulm from 2011 to 2017 was performed. Analysis was directed to determine a potential association of pre- and postoperative values of anti-recEm18 with clinical outcomes. RESULTS Anti-recEm18 had a linear correlation to the maximum lesion diameter (R2 = 0.558). Three trajectories of anti-recEm18 were identified based on a threshold of 10 AU/ml: "Em18-low" (n = 31), "responders" (n = 53) and "residual disease" (n = 4). The decline of anti-recEm18 in "responders" reached a plateau after 10.9 months at which levels decreased by 90%. The only patient with recurrence in the entire population was also the only patient with a secondary increase of anti-recEm18. CONCLUSION In patients with preoperative elevated values, anti-recEm18 confirms curative surgery at 12 months follow-up and allows for long-term surveillance.
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Affiliation(s)
- Severin Gloor
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Wanjie Jiang
- Department of Internal Medicine III, Division of Infectious Diseases, University Hospital of Ulm, Ulm, Germany
| | - Martin H Maurer
- Department for Diagnostic, Interventional, and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute for Diagnostic and Interventional Radiology, University Oldenburg, Oldenburg, Germany
| | - Bruno Gottstein
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland
| | - Alexander Oberli
- Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland
| | - Jürgen B Hagemann
- Institute of Medical Microbiology and Hygiene, University Hospital of Ulm, Ulm, Germany
| | - Julian F Hotz
- Department of Internal Medicine III, Division of Infectious Diseases, University Hospital of Ulm, Ulm, Germany; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anja Lachenmayer
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Beate Grüner
- Department of Internal Medicine III, Division of Infectious Diseases, University Hospital of Ulm, Ulm, Germany
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Zerem E, Puljiz Ž, Zdilar B, Kunosić S, Kurtcehajic A, Zerem O. What Is the Optimal Treatment for Liver Hydatid Cysts in Emergency and Elective Situations? Turk J Gastroenterol 2024; 35:158-159. [PMID: 38454248 PMCID: PMC10895872 DOI: 10.5152/tjg.2024.23523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/15/2023] [Indexed: 03/09/2024]
Affiliation(s)
- Enver Zerem
- Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Bistrik, Sarajevo, Bosnia and Herzegovina
| | - Željko Puljiz
- Department of Gastroenterology and Hepatology, University Clinical Center, Split, Croatia
| | - Boris Zdilar
- Department of Medicine, Croatian Military Academy, Ilica, Zagreb, Croatia
| | - Suad Kunosić
- Department of Physics, University of Tuzla Faculty of Natural Sciences and Mathematics, Tuzla, Bosnia and Herzegovina
| | - Admir Kurtcehajic
- Department of Gastroenterology and Hepatology, Blue Medical Group, Tuzla, Bosnia and Herzegovina
| | - Omar Zerem
- Department of Internal Medicine, Cantonal Hospital “Dr. Safet Mujić”, University of Mostar, Mostar, Bosnia and Herzegovina
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13
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Daduk Y, Seker A, Sozutek A, Olmez T, Kaplan K, Dur H, Ozdemir G. Treatment Options and the Management of Complications in Hydatid Cysts of the Liver in Endemic Regions. Ann Ital Chir 2024; 95:213-219. [PMID: 38684490 DOI: 10.62713/aic.3379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND Hydatid cyst of the liver induced by Echinococcus granulosus is a pervasive zoonotic disease in our region. Its incidence varies across age groups, contingent on community lifespans and hygiene standards. Therapeutic modalities include Puncture, Aspiration, Injection, Re-aspiration (PAIR), and surgery. Due the limited feasability of PAIR, we suggest that surgery represents the optimal treatment in all stages, especially in endemic regions, depending on patient-specific variables. METHOD Patients with hydatid cyst of the liver treated with PAIR and surgery in our center between January 2016 and January 2022 were analyzed retrospectively. PAIR or cystectomy were applied in treatment. These were then compared in terms of efficacy, feasibility, and complications. RESULTS A single hydatid cyst of the liver was detected in 184 of the 225 cases, two cysts in 33, and three or more cysts in eight. The largest cyst diameter was 233 × 124 mm in the surgery group and 100 × 90 mm in the PAIR group. One hundred thirty-three of the 225 patients underwent open surgery, and no recurrence was encountered in these. However, recurrence was observed 19 patients treated with PAIR. Allergic reaction developed in one case during surgery, postoperative abscess in two cases, biliary fistula in five, and pneumonia in one. CONCLUSION Surgical treatment should represent the standard procedure since it is safe and effective, ensures complete elimination of the parasite, involves no intraoperative shedding, preserves healthy tissues, and minimizes the risk of long-term recurrence and cavity-related complications.
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Affiliation(s)
- Yildiray Daduk
- Gastroenterological Surgery, Health Sciences University Adana City Training and Research Hospital, 01240 Adana, Turkey
| | - Ahmet Seker
- Gastroenterological Surgery, Health Sciences University Adana City Training and Research Hospital, 01240 Adana, Turkey
| | - Alper Sozutek
- Gastroenterological Surgery, Health Sciences University Adana City Training and Research Hospital, 01240 Adana, Turkey
| | - Tolga Olmez
- Gastroenterological Surgery, Health Sciences University Adana City Training and Research Hospital, 01240 Adana, Turkey
| | - Kuntay Kaplan
- Gastroenterological Surgery, Health Sciences University Adana City Training and Research Hospital, 01240 Adana, Turkey
| | - Huseyin Dur
- Gastroenterological Surgery, Health Sciences University Adana City Training and Research Hospital, 01240 Adana, Turkey
| | - Gorkem Ozdemir
- Gastroenterological Surgery, Health Sciences University Adana City Training and Research Hospital, 01240 Adana, Turkey
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14
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Huang M, Gao X, Liu J. Multiple hepatic alveolar echinococcosis infestation. Asian J Surg 2024; 47:544-545. [PMID: 37777416 DOI: 10.1016/j.asjsur.2023.09.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/15/2023] [Indexed: 10/02/2023] Open
Affiliation(s)
- Mengyue Huang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xuemei Gao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Jingjing Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Taşar P, Kılıçturgay SA. Gossypiboma mimicking hepatic hydatid cyst after 22 years: a case report. ULUS TRAVMA ACIL CER 2024; 30:68-71. [PMID: 38226569 DOI: 10.14744/tjtes.2023.05939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Gossypiboma is a non-absorbable material that is forgotten during surgery. These are medicolegal pathology that leads to diagnostic confusion from abscess to tumor. We present the case of gossypiboma detected in laparotomy in a 57-year-old male patient who had a history of operation due to a hydatid cyst 22 years ago and was referred to our center due to hydatid recurrence. The case should suggest a history of surgical gossypiboma, especially in asymptomatic patients. In this preventable pathology, the strategy during sur-gery and the careful and proper attitude of the surgical team are the main determinants.
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Affiliation(s)
- Pınar Taşar
- Department of General Surgery, Bursa Uludag University, Bursa-Türkiye
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16
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Chaouch MA, Ben Jabra S, Sayadi M, Toumi O, Noomen F. Severe Hypernatremia During Hydatid Cyst Surgery: An Anusual Cause Of Acute Abdomen. Ann Parasitol 2024; 69. [PMID: 38423520 DOI: 10.17420/ap6903/4.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Treatment of liver hydatid cysts is still in most cases surgical. To avoid the recurrence of hydatid cysts injection of scolicidal products inside the cystic cavity is an important step in the surgical procedure. Many scolicidal solutions are used. Hypertonic Saline Solution (HSS) is widely used by surgeons; however, there is a risk of hypertonic saline resorption and acute hypernatremia. Iatrogenic hypernatremia can be life-threatening. We report three cases of hypernatremia secondary to HSS injection for hydatid cyst disease treatment. The objective of this study was to discuss the clinical features, and treatment of this rare complication.
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Affiliation(s)
- Mohamed Ali Chaouch
- General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
| | - Sadok Ben Jabra
- General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
| | - Mouna Sayadi
- Department of Pharmacy, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
| | - Omar Toumi
- General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
| | - Faouzi Noomen
- General and Digestive Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
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17
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Luo Q, Wang X, Lei Q. Goal-directed fluid therapy for a patient undergoing liver resection for giant hepatic alveolar echinococcosis based on hypotension prediction index. Asian J Surg 2023; 46:5959-5961. [PMID: 37690899 DOI: 10.1016/j.asjsur.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023] Open
Affiliation(s)
- Qingyong Luo
- Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, 610000, China
| | - Xie Wang
- Department of Anesthesiology, Sichuan Provincial People's Hospital, 610000, China
| | - Qian Lei
- Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, 610000, China.
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Ortiz De Elguea-Lizarraga JI, Koi A, Stevenson HL, Bilek JM, Gosnell J, Wilhelm AB, McLellan S, Kueht ML. Liver Resection for Cystic Echinococcosis: Emergence of a Non-endemic Disease. Am Surg 2023; 89:6356-6358. [PMID: 37177876 DOI: 10.1177/00031348231175491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
| | - Avery Koi
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Heather L Stevenson
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Jill Marie Bilek
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Joseph Gosnell
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Susan McLellan
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Michael L Kueht
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
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Hammoodi SAR, Aftan KT, Ali MR. Management of Hydatid cysts of parotid glands. J Stomatol Oral Maxillofac Surg 2023; 124:101465. [PMID: 37030440 DOI: 10.1016/j.jormas.2023.101465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/10/2023]
Abstract
Hydatidosis (Echinococcosis) is a disease caused by infestation of hydatid cysts in any organ of body but mainly liver (70% of cases). Hydatidosis of salivary glands is rare and necessitate computerized tomography for diagnosis while fine needle aspiration remains controversial procedure. MATERIALS AND METHODS 6 patients diagnosed with hydatid cysts of parotid glands. These cases were admitted and treated at the maxillofacial surgery Clinic of the "AL-Ramadi" Hospital in Iraq. 5 patients were female and 1 male with age group was between 30 -50 years. The patients complained of painless unilateral swelling in parotid region and who were diagnosed hydatid cysts using CT. All cases were treated by superficial parotidectomy with cystectomy and preservation of facial nerve. RESULTS All hydatid cysts are CE1- type with no recurrences were reported in any of these cases. The postoperative edema was the most common complication. Other complications were not seen. CONCLUSION parotid hydatid cyst should be included in differential diagnosis of persistent parotid swelling especially those with history of hepatic hydatid cysts. Computerized tomography is the gold imaging that aid in diagnosis and classification of hydatid cysts. Most cases are CE1 type and Eosinophilia is a sign of concern in some patients. Surgical treatment remains the "gold standard" in therapy.
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Affiliation(s)
| | - Kamal Turki Aftan
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Anbar, Iraq
| | - Mohammed Rhael Ali
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Tikrit, Iraq
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20
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Yosra K, Ghada H, Bochra A, Fatma T, Said J, Riadh J. Predictive Factors of Liver Hydatid Cyst Recurrence in Children. J Pediatr Surg 2023; 58:2362-2367. [PMID: 37500372 DOI: 10.1016/j.jpedsurg.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Liver hydatid cyst affects approximately 95% of the world's echinococcosis cases. Despite advances in treatment, the recurrence rate remains high and is influenced by several factors that are yet to be determined. The objective of this study was to identify the predictive factors of liver hydatid cyst recurrence following surgery in children and to establish a treatment regimen aimed at preventing this postoperative morbidity. METHODS A bi-centric retrospective descriptive and analytic study was conducted involving 122 children who underwent surgery for liver hydatid cysts between January 1st, 2009, and December 31st, 2017. All factors that could potentially contribute to recurrence were thoroughly investigated. The data was processed using SPSS.v21, and a significant level of p-value 0.05 was applied. RESULTS Out of the 122 children, 20 patients experienced cyst recurrence (16.39%). Among them, there were nine girls and eleven boys. The median time of recurrence was 16.5 months. Abdominal ultrasonography demonstrated efficacy in detecting recurrence. Several factors were identified as predictors of postoperative recurrence, including intimate contact of the hydatid cyst with the large vessels (p = 0.031), intraperitoneal effusion (p = 0.042), bile duct dilation (p = 0.032), and postoperative spontaneous discontinuation of medical treatment (p = 0.010). Among these factors, two independent risk factors for recurrence were identified: intimate contact of the hydatid cyst with the large vessels (p = 0.011) and the presence of an intraperitoneal effusion (p = 0.018). CONCLUSION Our study has identified several predictors of postoperative recurrence, including two previously undocumented risk factors in the literature. Awareness of these risk factors can assist surgeons in implementing preventive measures to avoid the recurrence of hydatid cysts. LEVEL OF EVIDENCE Prognosis study Level II.
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Affiliation(s)
- Kerkeni Yosra
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia.
| | - Habachi Ghada
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Aziza Bochra
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Thamri Fatma
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Jlidi Said
- Department of Pediatric Surgery "B", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Jouini Riadh
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
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Manterola C, Rivadeneira J, Rojas C, Otzen T. Prevalence of cystic echinococcosis in relatives of patients undergoing surgery for hepatic cystic echinococcosis in an endemic region. PLoS Negl Trop Dis 2023; 17:e0011813. [PMID: 38064500 PMCID: PMC10732410 DOI: 10.1371/journal.pntd.0011813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/20/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is an endemic disease in southern Chile. The aim of this study was to ascertain the prevalence of CE among relatives of patients who underwent surgical intervention for this disease in Cautín, a province of southern Chile. METHODOLOGY/PRINCIPAL FINDINGS Cross-sectional study. Relatives of patients who underwent surgery for hepatic echinococcosis (HE), who lived at the same address, during the period 2000-2020 were studied. A total of 288 relatives of 322 patients who underwent surgery for HE participated in a CE screening. All these relatives were interviewed and underwent abdominal ultrasonography, chest X-ray and immunodiagnostic studies (relatives who had been diagnosed with or had undergone surgery for CE were excluded). Descriptive statistics were applied. Prevalence calculation, odds ratio (OR), and their respective 95% confidence intervals (95% CI) were determined. Abdominal or thoracic CE was verified in 42 relatives of subjects operated on for HE (mean age 41±8 years; 73.8% women; 38.1% of cases had two or more cysts), all of them new and asymptomatic cases. CE was detected in the lungs, liver, peritoneum, and spleen in 16.7%; 71.4%; 7.1%; and 4.8%, respectively. The overall prevalence of EQ during the studied time period was 14,6% (17.9% and 12.3% in relatives of first and second degree respectively (OR:1.56; CI 95%: 0.81; 3.01). CONCLUSION/SIGNIFICANCE There is a high prevalence of CE in relatives of patients undergoing surgery by this disease in the province of Cautín, Chile.
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Affiliation(s)
- Carlos Manterola
- Center for Morphological and Surgical Studies. Universidad de La Frontera. Chile
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Josue Rivadeneira
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
- Zero Biomedical Research, Quito, Ecuador
| | - Claudio Rojas
- Center for Morphological and Surgical Studies. Universidad de La Frontera. Chile
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
| | - Tamara Otzen
- PhD. Program in Medical Science, Universidad de La Frontera, Chile
- Núcleo Milenio de Sociomedicina. Santiago, Chile
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文 家, 王 奇, 费 帆, 廖 晓, 陈 勇, 袁 莉, 陈 增, 陈 隆, 徐 如, 刘 进. [Clinical Features and Surgical Outcomes of 15 Cases of Intracranial Alveolar Echinococcosis]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:1250-1255. [PMID: 38162060 PMCID: PMC10752774 DOI: 10.12182/20231160603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Indexed: 01/03/2024]
Abstract
Objective To investigate the surgical treatment strategy of intracranial alveolar echinococcosis (AE) and the clinical outcomes. Methods The clinical and follow-up data of 15 intracranial AE patients who underwent surgical treatment in the Departments of Neurosurgery of Sichuan Provincial People's Hospital (SPPH) and People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture (a branch hospital of SPPH) between March 2017 and January 2021 were retrospectively analyzed. Full follow-up data were available for each of the 15 cases. The clinical and imaging characteristics, general surgical information, and surgical outcomes were analyzed. Results In the 15 patients, there were a total of 50 intracranial lesions, with an average of (3.3±3.1)/case. Four cases had solitary intracranial lesions, while 11 cases had multiple lesions, with the number of intracranial lesions per case ranging from 2 to 13. All patients with solitary intracranial lesions received total resection. In 6 patients with multiple intracranial lesions, only the largest lesion was surgically removed, and in 5 patients, 2 to 3 adjacent lesions were surgically removed. All but one patient had extracranial lesions in their liver, lungs, kidneys, adrenal glands, and thoracic vertebrae. The patients were followed up for 12 to 58 months after surgery, with the mean follow-up time being (28.1±13.4) months. Among the 15 cases, 13 showed stable intracranial condition during postoperative follow-up. Intracranial lesions recurred in 2 patients who had deep lesions accompanied by dissemination to the subarachnoid space. Two patients died during follow-up. Conclusion Microsurgical treatment of intracranial AE is effective, but total surgical resection is difficult to accomplish when patients have echinococcosis lesions located at a depth, especially when the lesions are spreading to the subarachnoid space. The prognosis of patients is closely associated with the extent of lesion invasion and the control of systemic hydatid lesions, especially those in the liver.
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Affiliation(s)
- 家智 文
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 奇 王
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 帆 费
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 晓灵 廖
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 勇 陈
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 莉 袁
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 增雄 陈
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 隆益 陈
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 如祥 徐
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 进平 刘
- 阿坝藏族羌族自治州人民医院 神经外科 (马尔康 624000)Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
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Hu Q, Chen S, Fan Y, Lu Q, Deng M, Fan H. Kidney invasion occurred 2 years following liver transplantation for hepatic alveolar echinococcosis: a case report. BMC Infect Dis 2023; 23:785. [PMID: 37950231 PMCID: PMC10638689 DOI: 10.1186/s12879-023-08788-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The organ most commonly invaded in echinococcosis is the liver; the lungs, brain, kidneys, heart, and spleen are rarely invaded, and multi-organ involvement in echinococcosis is even rarer. No studies have reported renal invasion after liver transplantation for hepatic alveolar echinococcosis. CASE PRESENTATION We report here a case of renal invasion 2 years after allogeneic liver transplantation in a 53-year-old female patient with hepatic alveolar echinococcosis combined with lung metastases. At the time of the first consultation, the lesion had been found to involve the second hepatic hilum combined with lung metastases, but the patient requested conservative treatment, and the lesion was not controlled by taking albendazole for 3 years. After discussion in the treatment group, it was decided to use allogeneic liver transplantation and lung segmental resection for surgical treatment, after which the patient was put on long-term oral immunosuppression. She was hospitalized 2 years later for low back pain and diagnosed with renal alveolar echinococcosis. Due to significant compression and left-sided renal insufficiency, the final option was to remove the diseased kidney. It is worth mentioning that signs of unexplained urinary tract infection were present throughout the course of treatment. CONCLUSION This study suggests that extra attention should be paid to the presence of cryptogenic lesions in patients with hepatic alveolar echinococcosis who already have definite metastatic lesions. Immunosuppressive drugs after liver transplantation in patients with hepatic echinococcosis may cause occult lesions to develop into active ones. In clinical practice, particular attention should be paid to patients with hepatic alveolar echinococcosis with long-term concomitant signs of unexplained urinary tract infections, which may be a precursor clinical feature of cryptogenic renal alveolar echinococcosis.
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Affiliation(s)
- Qirui Hu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, 810001, China
- Qinghai Research Key Laboratory for Echinococcosis, Xining, Qinghai, 810001, China
| | - Simin Chen
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, 810001, China
- Qinghai Research Key Laboratory for Echinococcosis, Xining, Qinghai, 810001, China
| | - Yichen Fan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, Urumqi, 830054, China
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Qian Lu
- Department of Hepatopancreatobiliary Surgery, Tsinghua Changgung Hospital, Tsinghua University, Beijing, 102218, China
| | - Manjun Deng
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, 810001, China.
- Qinghai Research Key Laboratory for Echinococcosis, Xining, Qinghai, 810001, China.
| | - Haining Fan
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, 810001, China.
- Qinghai Research Key Laboratory for Echinococcosis, Xining, Qinghai, 810001, China.
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Lv T, Xu G, Xu X, Wu G, Wan CF, Song JL, Yang J, Zhou YJ, Luo K, Wu H, Ye CJ, Yan LN, Lau WY, Yang JY. A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series. Int J Surg 2023; 109:3262-3272. [PMID: 37994730 PMCID: PMC10651293 DOI: 10.1097/js9.0000000000000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/02/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Ex vivo liver resection combined with autotransplantation is an effective therapeutic strategy for unresectable end-stage hepatic alveolar echinococcosis (HAE). However, ex vivo liver resection combined with autotransplantation is a technically demanding and time-consuming procedure associated with significant morbidity and mortality. The authors aimed to present our novel remnant liver-first strategy of in vivo liver resection combined with autotransplantation (IRAT) technique for treating patients with end-stage HAE. METHODS This retrospective study included patients who underwent IRAT between January 2014 and December 2020 at two institutions. Patients with end-stage HAE were carefully assessed for IRAT by a multidisciplinary team. The safety, feasibility, and outcomes of this novel technique were analyzed. RESULTS IRAT was successfully performed in six patients, with no perioperative deaths. The median operative time was 537.5 min (range, 501.3-580.0), the median anhepatic time was 59.0 min (range, 54.0-65.5), and the median cold ischemia time was 165.0 min (range, 153.8-201.5). The median intraoperative blood loss was 700.0 ml (range, 475.0-950.0). In-hospital complications occurred in two patients. No Clavien-Dindo grade III or higher complications were observed. At a median follow-up of 18.6 months (range, 15.4-76.0) , all patients were alive. No recurrence of HAE was observed. CONCLUSION The remnant liver-first strategy of IRAT is feasible and safe for selected patients with end-stage HAE. The widespread adoption of this novel technique requires further studies to standardize the operative procedure and identify patients who are most likely to benefit from it.
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Affiliation(s)
- Tao Lv
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Gang Xu
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Xi Xu
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Gang Wu
- Department of Hepatobiliary Surgery, Qinghai Provincial People’s Hospital, Xining
| | - Chen-Fei Wan
- Department of Hepatobiliary Surgery, Qinghai Provincial People’s Hospital, Xining
| | - Jiu-Lin Song
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Jian Yang
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Yong-Jie Zhou
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Kui Luo
- Department of Radiology, Huaxi MR Research Center (HMRRC), National Clinical Research Center for Geriatrics, Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu
| | - Hong Wu
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Cheng-Jie Ye
- Department of Hepatobiliary Surgery, Qinghai Provincial People’s Hospital, Xining
| | - Lv-Nan Yan
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
| | - Wan-Yee Lau
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, People’s Republic of China
| | - Jia-Yin Yang
- Liver Transplant Center, Organ Transplant Center
- Laboratory of Liver Transplantation, Key Laboratory of Transplant Engineering and Immunology, NHC
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25
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Hong Y, Li H, Teng F, Chen Z. Two-step resection procedure for advanced hepatic alveolar echinococcosis: First case-series report. Asian J Surg 2023; 46:4829-4830. [PMID: 37586936 DOI: 10.1016/j.asjsur.2023.05.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 08/18/2023] Open
Affiliation(s)
- Ying Hong
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Li
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Teng
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - ZheYu Chen
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China.
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26
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Ma X, Su W, Wang X, Zhao R. Radical resection of hepatic alveolar echinococcosis combined with cystic echinococcosis: A case report. Medicine (Baltimore) 2023; 102:e35806. [PMID: 37904358 PMCID: PMC10615391 DOI: 10.1097/md.0000000000035806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
RATIONALE Hepatic Echinococcosis, is a zoonotic Parasitic disease with a worldwide distribution. Clinical cases of alveolar echinococcosis combined with cystic echinococcosis infection are extremely rare. PATIENT CONCERNS A 58-year-old patient had found liver occupying lesions for more than 2 years. A left hepatic alveolar hydatid was found, occupying the entire left half of the liver, with a size of approximately 6.7 cm × 10.9 cm × 8.1 cm. The size of the right liver is about 9 × 8 cm cystic hydatid, mainly located in the S5 segment of the liver. Abdominal examination: the upper abdomen is swollen, and a hard mass can be touched under the right rib margin, with tenderness and no rebound pain. The bowel sounds are normal. DIAGNOSES Abdominal MR shows an increase in liver volume and irregular morphology, with patchy abnormal signal shadows visible in the left lobe of the liver, with a range of approximately 6.7 cm × 10.9 cm × 8.1 cm, low signal on T1WI, low signal on T2WI and FS-T2WI, slightly high signal on diffusion weighted imaging, high signal on apparent diffusion coefficient, no significant enhancement of the lesion after enhancement. In addition, there is a clump like abnormal signal shadow visible in the right lobe of the liver, with a size of approximately 7.9 cm × 7.3 cm × 7.9 cm, low signal on T1WI, mixed high signal on T2WI, high signal on diffusion weighted imaging, mixed signal on apparent diffusion coefficient. Consider: Left lobe alveolar echinococcosis, and right lobe cystic echinococcosis (CE III type). INTERVENTIONS A radical resection was performed, including expanded left hemi-hepatectomy, cholecystectomy, right hepatic lesion resection, partial right hepatic duct resection with right hepatic duct jejunostomy. OUTCOMES The wound healed well after resection. There was no recurrence of TC after 4 years follow-up. LESSONS The co-infection of alveolar echinococcosis and cystic echinococcosis in a patient is an exceedingly rare occurrence. Radical resection is the only curative treatment.
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Affiliation(s)
- Xiaoguang Ma
- Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai, China
| | - Wei Su
- Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai, China
| | - Xiao Wang
- Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai, China
| | - Rui Zhao
- Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai, China
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27
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Aierken Y, Yang JY. Lung and brain recurrence after liver transplantation for advanced alveolar echinococcosis: A case report. Asian J Surg 2023; 46:4458-4459. [PMID: 37188591 DOI: 10.1016/j.asjsur.2023.04.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 04/21/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Yiliyaer Aierken
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jia-Yin Yang
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
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28
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Weber TF, Junghanss T, Stojković M. Pulmonary cystic echinococcosis. Curr Opin Infect Dis 2023; 36:318-325. [PMID: 37578473 PMCID: PMC10487362 DOI: 10.1097/qco.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
PURPOSE OF REVIEW The aim of our review is to summarize specific clinical, diagnostic and treatment aspects of pulmonary cystic echinococcosis. The lung is the organ second most affected by cystic echinococcosis with approximately a quarter of cystic echinococcosis cysts. Most cysts are in the liver. Apart from the watch and wait approach for selected inactive cysts [cystic echinococcosis CE4, CE5], the well established WHO cystic echinococcosis cyst classification-based treatment of hepatic cystic echinococcosis cannot be applied to pulmonary cystic echinococcosis cysts. Some standard interventions can even be harmful when applied to pulmonary cystic echinococcosis cysts. RECENT FINDINGS Cystic echinococcosis is one of the neglected tropical diseases (NTDs). Development of new diagnostics and treatment modalities is hampered by low investment into research and is accordingly slow. SUMMARY Surgery is the mainstay of treatment for pulmonary cystic echinococcosis cysts. Parenchyma-sparing surgical techniques should be used whenever possible. Albendazole induces decay of the parasitic cyst membrane, opening of cystobronchial fistulas and cyst complications, which can be life threatening. It is strongly recommended to seek advice from expert centres, including differential diagnoses, treatment and a long-term management plan.
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Affiliation(s)
| | - Thomas Junghanss
- Centre of Infectious Diseases, Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Marija Stojković
- Centre of Infectious Diseases, Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
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29
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Akhan O. Percutaneous treatment of liver hydatid cysts: to PAIR or not to PAIR. Curr Opin Infect Dis 2023; 36:308-317. [PMID: 37548385 DOI: 10.1097/qco.0000000000000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE OF REVIEW The aim is to review recent literature for percutaneous treatment of liver hydatid cysts (cystic echinococcosis: CE) via different techniques such as PAIR (puncture, aspiration, injection, and reaspiration), standard catheterization, and modified catheterization technique (MoCaT). RECENT FINDINGS PAIR is an established technique and considered to be safe and effective for CE1 and CE3a as it is associated with lower morbidity, mortality, recurrence, and shorter hospital stay as compared with surgery. Standard catheterization is also dedicated for the treatment of CE1 and CE3a. PAIR should be preferred for treatment of liver CE1 and CE3a cysts, since PAIR is associated with lower major complication rates and shorter hospital stay. However, standard catheterization technique is indicated when cysto-biliary fistula develops or any technical difficulty arises during the PAIR. In these cases it is needed to switch PAIR to standard catheterization to complete the procedure. SUMMARY For CE1 and CE3a cysts, PAIR and standard catheterization are the choice for percutaneous treatments, while MoCaT is a treatment option for CE2 and CE3b cysts.
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Affiliation(s)
- Okan Akhan
- Department of Radiology, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara, Turkey
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30
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Öter S, Yalçın M. Emergency/Elective Surgery and Emergency Percutaneous Interventions in Liver Hydatid Cysts and Their Results. Turk J Gastroenterol 2023; 34:1071-1077. [PMID: 36919888 PMCID: PMC10645287 DOI: 10.5152/tjg.2023.22818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/29/2022] [Indexed: 03/16/2023]
Abstract
BACKGROUND Hydatid cyst may remain asymptomatic for several years or may become complicated. The aim of this study is to evaluate the patients who were operated on for liver hydatid cyst in our clinic and the results of preoperative or postoperative complications. METHODS The data of 836 patients who underwent surgery (n = 750) or Puncture, Aspiration, Injection, and Re-aspiration (n = 86) for hydatid cyst disease in our clinic between January 2006 and January 2021 were evaluated retrospectively. RESULTS Surgical operation was performed in 750 of the patients and Puncture, Aspiration, Injection, and Re-aspiration procedure was performed in 89 of the patients. In the surgery and Puncture, Aspiration, Injection, and Re-aspiration group, respiratory distress, anaphylaxis, allergic rash, and urticaria were observed in 11 patients (8 in Puncture, Aspiration, Injection, and Re-aspiration group and 3 in open surgery group). All patients recovered with emergency medical interventions. Recurrence was observed after the percutaneous procedure in 11 cases and after surgery in 36 cases. There was no statistically significant difference between the surgical and Puncture, Aspiration, Injection, and Re-aspiration groups in terms of recurrence and cyst infection (P = .253 and P = .547, respectively). The incidence of the development of intrabiliary rupture, allergic reaction, and intraperitoneal rupture was found 135 (16.14%), 12 (1.43%), and 2 (0.23%) in our study, respectively. CONCLUSIONS Intraperitoneal or intrabiliary rupture is a rare but fatal complication of hydatid cyst. The presence of fever, jaundice, abdominal pain, urticaria, and anaphylactic reactions in endemic areas should take the suspicion of hydatid cyst rupture. The timing of surgery is an important factor affecting morbidity and mortality. Detailed exploration of the abdomen in emergency surgery for rupture hydatid cyst is essential for recurrence.
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Affiliation(s)
- Serdar Öter
- Department of Gastroenterological Surgery, Manisa City Hospital, Manisa, Turkey
| | - Metin Yalçın
- Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
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31
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Abbasi Dezfouli S, El Rafidi A, Aminizadeh E, Ramouz A, Al-Saeedi M, Khajeh E, Mieth M, Weber TF, Chang DH, Hoffmann K, Büchler MW, Mehrabi A. Risk factors and management of biliary leakage after Endocystectomy for hepatic cystic echinococcosis. PLoS Negl Trop Dis 2023; 17:e0011724. [PMID: 37906617 PMCID: PMC10637722 DOI: 10.1371/journal.pntd.0011724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/10/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Endocystectomy is a conservative surgical approach to managing cystic echinococcosis. Bile leakage is the main complication of this technique. The aim of this study was to evaluate the factors associated with bile leakage and to assess the outcomes and cost efficiency of strategies used to treat bile leakage. METHODOLOGY/PRINCIPAL FINDINGS Patients who underwent endocystectomy between 2005 and 2020 were included. The preoperative characteristics, intra- and postoperative outcomes, hospital costs, and cost efficiency (the Diagnosis-Related Group reimbursement minus the overall cost) were evaluated prospectively. A total of eighty patients with 142 cysts were included. Postoperative complications occurred in 17 patients (21%), including 11 patients with bile leakage (type A: 1, type B: 6 and type C: 4 patients, total 13%). Bile leakage was more frequent in patients with preoperative MRI signs of cysto-biliary fistulas or intraoperative visible cysto-biliary fistulas (p = 0.03 and p = 0.04, respectively) and in patients with cysts larger than 8 cm (p = 0.03). Patients with bile leakage who underwent reoperation (type C) had significantly shorter hospital stays (9 vs. 16 days, p<0.01) and better cost efficiency than those who received radiologic or endocscopic interventions (€2,072 vs. -€2,097 p = 0.01). No mortality was observed, and recurrence was seen in two patients. CONCLUSIONS/SIGNIFICANCE Endocystectomy is a safe and efficient technique. Preoperative and intraoperative cysto-biliary fistulas and a cyst diameter larger than 8 cm are correlated to postoperative bile leakage. Early operative management of bile leakage reduces hospital stay and improves cost efficiency compared with radiologic or endoscopic treatments.
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Affiliation(s)
- Sepehr Abbasi Dezfouli
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ahmad El Rafidi
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ehsan Aminizadeh
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Ramouz
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Mohammed Al-Saeedi
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Elias Khajeh
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus Mieth
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Frederik Weber
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - De-Hua Chang
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Kathrin Hoffmann
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
| | - Markus W Büchler
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Germany
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32
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Kalogeropoulu SK, Schwierz E, Meyerhoff M, Ratjszczak R, Nadler T, Raphael BL. ULTRASOUND-GUIDED PERCUTANEOUS TREATMENT OF HEPATIC HYDATIDOSIS IN TWO RED-SHANKED DOUC LANGURS ( PYGATHRIX NEMAEUS). J Zoo Wildl Med 2023; 54:645-650. [PMID: 37817632 DOI: 10.1638/2022-0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 10/12/2023] Open
Abstract
Hydatid disease caused by Echinococcus ortleppi is a major cause of morbidity and mortality for critically endangered captive langurs in northern Vietnam. The most common sites for hydatid cyst development are the liver and the lungs. Chemotherapy trials with albendazole alone or in combination with praziquantel in these langurs had varying results and in most cases were ineffective. Ultrasound-guided percutaneous aspiration of cystic fluid followed by instillation and re-aspiration of a scolicidal agent (PAIR technique), has gained importance in the treatment of active hepatic cysts in humans and in many cases is preferred over surgical and endoscopic approaches. The PAIR technique was used in two red-shanked douc langurs (Pygathrix nemaeus) for the treatment of unilocular active hepatic cysts. The technique was found to be fairly easy to perform, safe, and effective and should be a useful treatment tool for hepatic hydatidosis in langurs and other nonhuman primate species.
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Affiliation(s)
- Szilvia K Kalogeropoulu
- Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, Vienna, A-1160, Austria,
| | - Elke Schwierz
- Endangered Primate Rescue Center, Cuc Phuong National Park, Cuc Phuong, 43000, Ninh Binh, Vietnam
| | | | - Radoslaw Ratjszczak
- Endangered Primate Rescue Center, Cuc Phuong National Park, Cuc Phuong, 43000, Ninh Binh, Vietnam
| | - Tilo Nadler
- Three Monkeys Wildlife Conservancy, Cuc Phuong Village, 43000, Ninh Binh, Vietnam
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Berto CG, Liou P, Coyle CM, Emond JC. Surgical management of cystic echinococcosis of the liver. Curr Opin Infect Dis 2023; 36:348-352. [PMID: 37548389 DOI: 10.1097/qco.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE OF REVIEW Cystic echinococcosis is a zoonotic infection frequently involving the liver. Treatment options, including surgery, are decided based on the staging of the disease. RECENT FINDINGS Ultrasound is the cornerstone for diagnosis, staging, and follow-up of cystic echinococcosis. MRI can help to evaluate for cystobiliary complications and planning of the surgery. The two main surgical approaches for cystic echinococcosis include a radical approach, which entails a partial hepatectomy and total pericystectomy, and a conservative approach or endocystectomy. Recent data suggest a conservative approach is well tolerated with acceptable morbidity and no mortality. Recurrences in centers with experience are rare. Data on laparoscopic surgery is emerging, but long-term follow-up still needs to be improved. SUMMARY Surgical treatment options should be carefully evaluated according to the cystic echinococcosis disease staging. A multidisciplinary approach, including diagnostic and interventional radiology, abdominal and liver surgery, and infectious diseases, results in better outcomes.
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Affiliation(s)
- Cesar G Berto
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Peter Liou
- Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York
| | - Christina M Coyle
- Division of Infectious Disease, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jean C Emond
- Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York
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Xia P, Wang XQ, Tian QS, Shang-Guan CL, Zhu HH. Case Report: Semi-Ex Vivo Hepatectomy Combined with Autologous Liver Transplantation for Alveolar Echinococcosis in Children. Am J Trop Med Hyg 2023; 109:640-644. [PMID: 37549899 PMCID: PMC10484275 DOI: 10.4269/ajtmh.23-0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/06/2023] [Indexed: 08/09/2023] Open
Abstract
Hepatic alveolar echinococcosis (AE) is a zoonotic disease caused by the metacestode of Echinococcus multilocularis. Although surgical resection is the optimal treatment for hepatic AE, some patients with hepatic AE located in special introhepatic sites cannot be radically cured by conventional surgery. Here, we report that a 10-year-old female patient was admitted to the hospital with occupying liver lesions for 6 months. Computed tomography examination showed irregular mixed-density masses in the right lobe and caudate lobe of the liver, with partial invasion of the right hepatic artery, right hepatic vein, and right branch of the portal vein. The patient was preoperatively diagnosed with hepatic AE, which cannot be cured by conventional liver lobectomy. The patient underwent semi-ex vivo liver resection with autologous liver transplantation (second hepatic portal reconstruction, posterior hepatic inferior vena cava repair, and hepatic artery repair) and biliary-intestinal anastomosis. After hospital discharge, she has kept living a healthy life without disease recurrence for 13 months until the end of the last follow-up. This case shows that semi-ex vivo hepatectomy with autologous liver transplantation might be a feasible and safe choice for certain patients with AE located in special introhepatic sites, which has provided novel experiences for the surgical treatment of hepatic AE.
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Affiliation(s)
- Pan Xia
- Department of Graduate School, Qinghai University, Xining, China
| | - Xiang-Qian Wang
- Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, China
| | - Qing-Shan Tian
- Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, China
| | | | - Hai-Hong Zhu
- Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, China
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Kaya V, Tahtabasi M, Konukoglu O, Yalcin M. Percutaneous Treatment of Giant Hydatid Cysts and Cystobiliary Fistula Management. Acad Radiol 2023; 30 Suppl 1:S132-S142. [PMID: 37120402 DOI: 10.1016/j.acra.2023.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 05/01/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the efficacy and safety of percutaneous treatment in cystic echinococcosis (CE) type 1 and 3a giant cysts (with at least one diameter>10 cm) according to the World Health Organization classification and to evaluate the management of complications, especially cystobiliary fistulas (CBFs). MATERIALS AND METHODS This retrospective study included 66 patients with 68 CE1 and CE3a giant cysts treated with percutaneous catheterization between January 2016 and December 2021. The characteristics of the cysts, major and minor complications, time to catheter removal, and length of hospital stay were recorded. RESULTS Among the 68 cysts, CBFs occurred in 35 (51.5%), cavity infections in 11 (16.1%), recollection in five (7.4%), and anaphylaxis in three (4.5%). There was no mortality. Biliary drainage was observed intraoperatively in 20 (29.4%) and only postoperatively in 15 (22.1%) of the 35 cysts with CBFs. A plastic biliary stent was placed in 18 (51.5%) of the 35 cysts with CBFs. The patients with CBFs had a longer hospital stay and time to catheter removal than those without fistulas (15.3 ± 10.9 vs. 6.1 ± 2.6 days and 32.7 ± 51.8 vs. 6.2 ± 3.1 days, respectively; P < 0.001). Of the patients who developed recollection, three were treated with secondary catheterization, and two underwent surgery. In total, three patients underwent surgery. The rate of clinical success was 95.4%. All cysts were followed up for an average of 19.1 (range, 12-60) months, and there was an average 88.8% reduction in cyst volume compared to the initial evaluation. CONCLUSION CE1 and CE3a giant cysts can be treated effectively and safely with high clinical success using the catheterization technique. Contrary to what has previously been reported for these patients, the rate of CBFs is high, but these patients can successfully be treated with percutaneous drainage and/or endoscopic retrograde cholangiopancreatography without the requirement of surgery.
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Affiliation(s)
- Veysel Kaya
- Department of Radiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey (V.K.).
| | - Mehmet Tahtabasi
- Department of Radiology, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.T., O.K.).
| | - Osman Konukoglu
- Department of Radiology, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.T., O.K.).
| | - Metin Yalcin
- Department of General Surgery, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.Y.).
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Elmoghazy W, Alqahtani J, Kim SW, Sulieman I, Elaffandi A, Khalaf H. Comparative analysis of surgical management approaches for hydatid liver cysts: conventional vs. minimally invasive techniques. Langenbecks Arch Surg 2023; 408:320. [PMID: 37594574 PMCID: PMC10439030 DOI: 10.1007/s00423-023-03043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Hydatid liver disease is a prevalent condition in endemic areas, particularly in the Middle East and North Africa. The use of laparoscopy as a treatment option has gained popularity. However, there is still ongoing debate regarding the optimal approach for surgical management. In this study, we present our experience with the surgical treatment of hydatid liver disease comparing conventional and minimally invasive approaches, including laparoscopic and robotic options. METHODS We conducted a retrospective review of patients who underwent surgery for hydatid liver disease at our institution. Data was collected on the patients' clinical presentations, cyst characteristics, surgical procedures performed, intraoperative findings, and postoperative complications. RESULTS A total of 98 hydatid liver cysts were surgically managed in 57 patients. The mean age of the patients was 37.2 ± 10.2 years, with 38 (66.7%) being male. Among the patients, 14 (24.6%) underwent conventional surgery (6 partial pericystectomy, 4 total pericystectomy, and 4 liver resection), 37 (64.9%) underwent laparoscopic surgery (31 partial pericystectomy, 4 total pericystectomy, and 2 liver resection), and 6 (10.5%) underwent robotic surgery (6 partial pericystectomy). There were no significant differences between the conventional surgery and minimally invasive groups in terms of patient age, gender, cyst size, or number. However, laparotomy was associated with a higher number of total pericystectomy and liver resection procedures compared to the minimally invasive approach (P = 0.010). Nonetheless, the operation time and blood loss were comparable between both groups. Perioperative complications occurred in 19 (33.3%) patients, with 16 (84%) experiencing minor issues. Bile leak occurred in 8 (14%) patients, resolving spontaneously in 5 patients. There was no significant difference (P = 0.314) in the incidence of complications between the two groups. Conventional surgery, however, was associated with a significantly longer hospital stay (P = 0.034). During follow-up, there were no cases of mortality or cyst recurrence in our cohort. CONCLUSION Minimally invasive approaches for hydatid liver cysts offer advantages such as shorter hospitalization and potentially quicker recovery, making them valuable treatment options when accompanied by careful patient selection and adherence to proper surgical techniques.
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Affiliation(s)
- Walid Elmoghazy
- Department of Surgery, Organ Transplant Section, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar.
- Department of Surgery, Sohag University, Sohag, Egypt.
| | - Jowhara Alqahtani
- Department of Surgery, Organ Transplant Section, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Seon Woo Kim
- Department of Medicine, Weill-Cornell Medical College, Doha, Qatar
| | - Ibnouf Sulieman
- Department of Surgery, Organ Transplant Section, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Ahmed Elaffandi
- Department of Surgery, Organ Transplant Section, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
- Department of Surgery, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hatem Khalaf
- Department of Surgery, Organ Transplant Section, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
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Ammar H, Dammak N, Ben Latifa M, Said MA, Azri M, Gupta R, Ben Hamada H, Belkacem O, Ben Mabrouk M, Ben Ali A. Rupture of a liver hydatid cyst into the right portal vein leading to right portal vein thrombosis: a case report and literature review. J Int Med Res 2023; 51:3000605231191018. [PMID: 37572078 PMCID: PMC10423452 DOI: 10.1177/03000605231191018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/13/2023] [Indexed: 08/14/2023] Open
Abstract
Hydatid disease (HD) is a worldwide parasitic disease. HD is endemic in many sheep- and cattle-raising areas, with a high prevalence of 5% to 10% in the Mediterranean region. Fistulation of liver hydatid cysts (LHC) in the bile ducts is the most common complication, followed by rupture of cysts in the peritoneal and thoracic cavities. Vascular complications are a rare complication of HD. We describe the case of a 70-year-old woman who was admitted with the chief complaint of pain in the abdominal right upper quadrant for 6 months. Abdominal computed tomography revealed a large LHC in the right liver that had ruptured into the right portal vein branch, with venous thrombosis. Intraoperatively, the right portal vein was opened longitudinally, and the hydatid contents were evacuated. Right hepatectomy was performed to completely excise the LHC. The penetration of a cyst into an adjoining vessel is very rare, and portal vein invasion by HD is extremely rare, with only 10 cases published in the literature, to the best of our knowledge.
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Affiliation(s)
- Houssem Ammar
- Department of Gastrointestinal Surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Nouha Dammak
- Department of Gastrointestinal Surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Mahdi Ben Latifa
- Department of Gastrointestinal Surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Mohamed Amine Said
- Department of Gastrointestinal Surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Marwa Azri
- Department of Gastrointestinal Surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Rahul Gupta
- Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India
| | - Habiba Ben Hamada
- Department of Anesthesiology, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Oussama Belkacem
- Department of Pathology, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Mohamed Ben Mabrouk
- Department of Gastrointestinal Surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Ali Ben Ali
- Department of Gastrointestinal Surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
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Özdemir M, Türk G, Bilgili M. Percutaneous treatment of giant hydatid cysts: a single-center experience of 58 cysts. Abdom Radiol (NY) 2023; 48:1409-1414. [PMID: 36774554 DOI: 10.1007/s00261-023-03841-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/13/2023]
Abstract
PURPOSE The aim of this study is to evaluate the efficacy of percutaneous treatment in hydatid cysts (HCs) with at least one diameter larger than 10 cm. MATERIALS AND METHODS 58 CE1 or CE3a HCs with at least one diameter larger than 10 cm which were treated with catheterization between September 2016 and December 2021 were retrospectively analyzed. RESULTS Mean age was 40 ± 17.7 (18-80). Majority of HCs were in the liver (89.6%). Median follow-up was 28 months. Technical success rate was 100%; however, a second procedure was needed in 13 cysts due to recollection (n = 4), infection (n = 6), and recurrence (n = 3). CONCLUSIONS Giant HCs can be effectively treated with catheterization with low complication rates.
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Affiliation(s)
- Mustafa Özdemir
- Department of Radiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
| | - Gamze Türk
- Department of Radiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Mustafa Bilgili
- Department of Radiology, Kayseri Education and Research Hospital, Kayseri, Turkey
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Wang Z, Yang JY, Xia P, Zhu HH, Gai ZG. Misdiagnosis of hepatic cystic echinococcosis complicated with hepatocellular carcinoma: A case report. Medicine (Baltimore) 2022; 101:e32291. [PMID: 36595756 PMCID: PMC9794291 DOI: 10.1097/md.0000000000032291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
RATIONALE Hepatic cystic echinococcosis (CE) is a common zoonotic parasitic disease caused by the entry of Echinococcus granulosus eggs into human body. Surgical resection is the optimal treatment choice for hepatic CE. However, Coexistence of CE and hepatocellular carcinoma (HCC) have been reported with a rare incidence rate, which led to unsatisfactory prognosis after the operation. PATIENT CONCERNS A 69-year-old male patient was admitted to hospital because of "Upper abdominal pain and discomfort for more than 1 month and an aggravation for 10 days." DIAGNOSIS An elderly male herder who was initially diagnosed as hepatic CE, and none of the preoperative imaging test revealed the existence of HCC. Co-existence of hepatic CE and HCC was confirmed by the postoperative pathological examination. INTERVENTIONS The patient underwent "combined hepatic segmental resection, portal vein thrombectomy, portal vein repairment, hepatic hydatid internal capsule removal and external subtotal resection, cholecystectomy". OUTCOMES During follow-up after discharge, the patient did not regularly review and get further treatment and died 8 months after operation. LESSONS May improve the clinicians' understanding of CE complicated with HCC, and reduce the misdiagnosis of similar case, as well as provide guidance for clinical treatment.
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Affiliation(s)
- Zheng Wang
- Department of Graduate School, Qinghai University, Xining, Qinghai Province, China
| | - Jin-Yu Yang
- Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, Qinghai Province, China
| | - Pan Xia
- Department of Graduate School, Qinghai University, Xining, Qinghai Province, China
| | - Hai-Hong Zhu
- Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, Qinghai Province, China
- * Correspondence: Hai-Hong Zhu, Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, Qinghai Province 810007, China (e-mail: )
| | - Zhi-Gang Gai
- Department of Graduate School, Qinghai University, Xining, Qinghai Province, China
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A JD, Chai JP, Zhao SY, An XR, Yang JY, An X. [Research progress on infiltrating zone and microvascular invasion of hepatic alveolar echinococcosis]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1514-1519. [PMID: 36274623 DOI: 10.3760/cma.j.cn112150-20211118-01062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Hepatic alveolar echinococcosis (AE) is a parasitic disease with biological characteristics similar to malignant tumor. It has no obvious clinical symptoms in the early stage. Most patients have complications such as jaundice, ascites and gastrointestinal bleeding when they see a doctor. At this time, the course of disease is at an advanced stage. In addition, the incomplete resection of the AE lesion(s) leads to a high postoperative recurrence rate, which has a serious impact on the physical and mental health of patients. Based on the summary of the latest research at home and abroad and the analysis of blood supply, microvascular invasion and vascular growth factor expression in the "infiltrating zone" adjacent to the lesions of hepatic AE, this article has a deep understanding of the occurrence and development process of hepatic AE, aiming to better guide clinical practice and improve the quality of life of patients.
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Affiliation(s)
- J D A
- Graduate School,Soochow University, Suzhou 215000, China Department of General Surgery,Qinghai Provincial People's Hospital, Xining 810007, China
| | - J P Chai
- Department of Cardiology,Qinghai Provincial People's Hospital, Xining 810007, China
| | - S Y Zhao
- Department of General Surgery,Qinghai Provincial People's Hospital, Xining 810007, China
| | - X R An
- Department of Clinical Laboratory,Qinghai Provincial People's Hospital, Xining 810007, China
| | - J Y Yang
- Department of General Surgery,Qinghai Provincial People's Hospital, Xining 810007, China
| | - Xiuqing An
- Graduate School,Qinghai University, Xining 810007, China
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A J, Chai J, Shao Z, Zhao S, Wang H, A X, Yang J. Comparison of local ablation with Albendazole or laparoscopic hepatectomy combined with Albendazole in the treatment of early hepatic alveolar echinococcosis. Front Public Health 2022; 10:960635. [PMID: 36276387 PMCID: PMC9580460 DOI: 10.3389/fpubh.2022.960635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
Background Echinococcosis (E) is a zoonotic parasitic disease caused by the larval morphology of echinococcosis tapeworms. Among the recognized species, two are of medical importance-E. granulosus and E. multilocularis-causing cystic echinococcosis (CE) and alveolar echinococcosis (AE) in humans, respectively. Diagnosis of AE is based on clinical manifestation and epidemiological data, imaging techniques, histopathology and/or nucleic acid detection, and serology. At present, WHO guidelines suggest that benzimidazoles (BMZ) are mandatory in all AE patients, temporarily after complete resection of the lesions and for life in all other AE cases. Interventional procedures should be preferred to palliative surgery whenever possible, and radical surgery is the first choice in all cases suitable for total resection of the lesion. However, some research centers have proposed that local ablation (LA) including radiofrequency ablation (RFA) and microwave ablation (MWA) is no less effective than radical surgery or better than simple medication in the early stage hepatic AE (WHO-IWGE PNM classification of AE: P1N0M0). This study attempted to compare the real efficacy of the above treatment methods, so as to find the best treatment for this kind of patient. Methods The data of patients with hepatic AE who underwent laparoscopic hepatectomy (LH), RFA, and MWA in Qinghai Provincial People's Hospital from January 2015 to January 2021 were collected. At the same time, the cases treated with Albendazole (ABZ) were collected together with the institution for disease control and prevention. According to the treatment methods, the above cases were divided into LH group, RFA group, MWA group, and medication group. The basic data and postoperative recovery indices of the four groups were compared, respectively. Results A total of 199 patients with hepatic AE were enrolled in this study, including 90 males and 109 females. The youngest was 5 years old and the oldest was 66 years old, with an average of 33.41±14.64 years old. 20.6% of the patients had hepatitis B (41/ 199). A total of 45 patients underwent ultrasound-guided RFA, 47 patients underwent ultrasound-guided MWA, 51 patients were treated with ABZ, and 56 patients underwent LH. There were no significant differences in baseline characteristics among the four groups (p > 0.05). The RFA group and MWA group were more advantageous than the LH group regarding operation time and incidence of postoperative complications (p < 0.05). But recurrence rate of the lesion in the LH group was significantly lower than the RFA group, MWA group, and medication group. However, there was no significant difference in recurrence-free survival time among the four groups (p >0.05). Conclusion LH has a significant effect in the treatment of early-stage hepatic AE, especially in terms of recurrence which is significantly better than LA and medication alone. Follow-up and adherence to ABZ therapy are essential if conservative treatment is to achieve better outcomes.
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Affiliation(s)
- Jide A
- Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining, China
| | - Jinping Chai
- Department of Internal Medicine-Cardiovascular, Qinghai Provincial People's Hospital, Xining, China
| | - Zongping Shao
- Department of Anesthesiology, The First People's Hospital of Kashi Prefecture, Kashi, China
| | - Shunyun Zhao
- Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining, China
| | - Hao Wang
- Intensive Care Unit, Qinghai Provincial People's Hospital, Xining, China
| | - Xiangren A
- Department of Clinical Laboratory, Qinghai Provincial People's Hospital, Xining, China
- Department of Clinical Laboratory, Qinghai Province Key Laboratory of Laboratory Medicine, Xining, China
- Department of Clinical Laboratory, Qinghai Clinical Medical Research Center, Xining, China
| | - Jinyu Yang
- Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining, China
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Ji J, Zhang Y, Yang C. Hepatic caudate epithelioid angiomyolipoma mimics hydatid cyst. Asian J Surg 2022; 46:1700-1701. [PMID: 36270941 DOI: 10.1016/j.asjsur.2022.09.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Junchong Ji
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yu Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China; Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province & Organ Transplantation Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Chong Yang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province & Organ Transplantation Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China.
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Gloor S, Candinas D, Beldi G, Lachenmayer A. Laparoscopic resection of hepatic alveolar echinococcosis: A single-center experience. PLoS Negl Trop Dis 2022; 16:e0010708. [PMID: 36067177 PMCID: PMC9447893 DOI: 10.1371/journal.pntd.0010708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/29/2022] [Indexed: 12/07/2022] Open
Abstract
Introduction Alveolar echinococcosis (AE) remains a very rare disease requiring complete radical resection for curative treatment. While open approaches are common, safety and efficacy of laparoscopic resections remain unknown. Methods This is a single-center, retrospective cohort study with patients undergoing liver resection for hepatic AE at the Department of Visceral Surgery and Medicine, Bern University Hospital from December 2002 to December 2020. Postoperative outcomes of patients following laparoscopic hepatectomy (LH) for hepatic AE were compared with those of patients undergoing open hepatectomy (OH). Results A total of 93 patients underwent liver resection for hepatic AE. Laparoscopic hepatectomy was performed in 23 patients and open hepatectomy in 70 patients. While there were no significant differences in terms of gender, age and diagnostic tools, the majority of patients of the LH cohort were PNM stage 1 (78%) in contrast to only 39% in the OH cohort (p = 0.002). Patients undergoing laparoscopic hepatectomy were treated by minor liver resections in 91% and in 9% by major liver resections in comparison to the open hepatectomy cohort with 61% major liver resections and 39% minor resections. Laparoscopic hepatectomy was associated with shorter mean operation time (127 minutes vs. 242 minutes, p <0.001), lower major complication rate (0% vs. 11%, p = 0.322) and shorter mean length of hospital stay (4 days vs. 13 days, p <0.001). Patients with LH had a distinct, but not significant lower recurrence rate (0% vs. 4%, p = 0.210) during a mean follow-up of 55 months compared with a follow-up of 76 months in the OH cohort. After subgroup analysis of PNM stage 1 patients, similar results are seen with persistent shorter mean operation time (120 minutes vs. 223 minutes, p <0.001), lower major complication rate (0% vs. 8%, p = 0.759) and shorter length of hospital stay (4 days vs. 12 days, p <0.001). Conclusion Laparoscopy appears as a feasible and safe approach for patients with PNM stage 1 alveolar echinococcosis without impact on early disease recurrence. In this retrospective cohort study laparoscopic hepatectomy for hepatic alveolar echinococcosis had no negative impact on perioperative outcomes, disease recurrence or survival compared with open hepatectomy. The importance of this finding is that the laparoscopic approach is feasible and safe for selected patients with hepatic alveolar echinococcosis, especially those with PNM stage 1.
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Affiliation(s)
- Severin Gloor
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Anja Lachenmayer
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
- * E-mail:
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智 明, 庞 华, 王 文. [Relationship Between the Level of Anatomical Risk of Hepatic Alveolar Echinococcosis and Complications after Radical Resection]. Sichuan Da Xue Xue Bao Yi Xue Ban 2022; 53:770-776. [PMID: 36224677 PMCID: PMC10408804 DOI: 10.12182/20220960108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 06/16/2023]
Abstract
Objective To analyze the impact of high or low levels of anatomical risk of hepatic alveolar echinococcosis (HAE) on complications after radical resection. Methods The baseline, surgical, and complication data were retrospectively collected from hepatic alveolar echinococcosis patients who underwent radical resection at the Ganzi Branch Hospital, West China Hospital, Sichuan University from 2015 to 2022. The patients were divided into anatomical low-risk (ALR) and anatomical high-risk (AHR) groups based on the PNM staging system designed by the World Health Organization (WHO-PNM). Complications were analyzed according to the Clavien-Dindo classification. Univariate and multivariate logistic regression analyses were performed to assess the effect of high and low risks of lesion anatomy on complications. Results Radical surgery was performed in 216 HAE patients and 102 of whom were in the AHR group. The median operative time was 230 (175, 300) min, the median intraoperative blood loss was 600 mL, and 129 (59.7%) patients developed complications. The complication rate was 73.5% (75/102) in the AHR group and 47.4% (54/114) in the ALR group, demonstrating statistically significant difference ( P<0.05). The incidence of serious complications was 36.3% (37/102) in the AHR group and 13.2% (15/114) in the ALR group, demonstrating statistically significant difference ( P<0.05). There was significant difference in the proportions of patients having postoperative complications of bile leak, anemia, fever, pleural effusion and ascites between the AHR group and the ALR group ( P<0.05). Multivariate logistic regression analysis suggested that AHR was the only independent risk factor for complications, including bile leak, anemia, fever, and pleural effusion, and severe complications. Conclusion The anatomical risk of hepatic alveolar echinococcosis is independently associated with the development of multiple postoperative complications, and physicians should choose surgical procedures cautiously according to the actual situation when dealing with patients defined as AHR according to WHO-PNM.
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Affiliation(s)
- 明 智
- 四川大学华西医院 肝脏外科 (成都 610041)Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院甘孜分院 肝胆二科 (康定 626000)The Second Department of Hepatobiliary Surgery, People's Hospital of Ganzi Prefecture, Kangding 626000, China
- 四川省包虫病临床医学研究中心 (康定 626000)Clinical Research Center of Hydatidosis of Sichuan Province, Kangding 626000, China
| | - 华胜 庞
- 四川大学华西医院 肝脏外科 (成都 610041)Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 文涛 王
- 四川大学华西医院 肝脏外科 (成都 610041)Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院甘孜分院 肝胆二科 (康定 626000)The Second Department of Hepatobiliary Surgery, People's Hospital of Ganzi Prefecture, Kangding 626000, China
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Maimaitinijiati Y, AJi T, Jiang TM, Ran B, Shao YM, Zhang RQ, Guo Q, Wang ML, Wen H. Approaches to reconstruction of inferior vena cava by ex vivo liver resection and autotransplantation in 114 patients with hepatic alveolar echinococcosis. World J Gastroenterol 2022; 28:4351-4362. [PMID: 36159005 PMCID: PMC9453774 DOI: 10.3748/wjg.v28.i31.4351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/10/2022] [Accepted: 07/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatic alveolar echinococcosis (AE) is most commonly found in retrohepatic inferior vena cava (RHIVC). Ex vivo liver resection and autotransplantation (ELRA) can better realize the radical resection of end-stage hepatic AE with severely compromised hepatocaval confluences, and reconstruction of the affected vessels. Currently, there is a scarcity of information regarding RHIVC reconstruction in ELRA.
AIM To propose reasonable RHICV reconstruction strategies for ex vivo liver resection and autotransplantation.
METHODS We retrospectively summarized the clinical data of 114 patients diagnosed with hepatic AE who treated by ELRA in our department. A total of 114 patients were divided into three groups according to the different reconstruction methods of RHIVC: Group A with original RHIVC being repaired and reconstructed (n = 64), group B with RHIVC being replaced (n = 43), and group C with RHIVC being resected without reconstruction (n = 7). The clinical data of patients, including the operation time, anhepatic phase, intraoperative blood loss, complications and postoperative hospital stay, were analyzed and the patients were routinely followed up. The normally distributed continuous variables were expressed as means ± SD, whereas the abnormally distributed ones were expressed as median and analyzed by analysis of variance. Survival curve was plotted by the Kaplan-Meier method.
RESULTS All patients were routinely followed up for a median duration of 52 (range, 12-125) mo. The 30 d mortality rate was 7.0% (8/114) and 7 patients died within 90 d. Among all subjects, the inferior vena cava (IVC)-related complication rates were 17.5% (11/63) in group A and 16.3% (7/43) in group B. IVC stenosis was found in 12 patients (10.5%), whereas thrombus was formed in 6 patients (5.3%). Twenty-two patients had grade III or higher complications, with the complication rates being 17.2%, 16.3%, and 57.1% in the three groups. The average postoperative hospital stay in the three groups was 32.3 ± 19.8, 26.7 ± 18.2, and 51.3 ± 29.4 d (P = 0.03), respectively.
CONCLUSION ELRA can be considered a safe and feasible option for end-stage hepatic AE patients with RHIVC infiltration. The RHIVC reconstruction methods should be selected appropriately depending on the defect degree of AE lesions in IVC lumen. The RHIVC resection without any reconstruction method should be considered with caution.
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Affiliation(s)
- Yusufukadier Maimaitinijiati
- State Key Laboratory on Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Clinical College, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Tuerganaili AJi
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Tie-Min Jiang
- State Key Laboratory on Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Clinical College, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Bo Ran
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Ying-Mei Shao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
- Xinjiang Organ Transplant Institution, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Rui-Qing Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Qiang Guo
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Mao-Lin Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Hao Wen
- State Key Laboratory on Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Clinical College, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
- Xinjiang Organ Transplant Institution, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
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Jaén-Torrejimeno I, López-Guerra D, Rojas-Holguín A, De-Armas-Conde N, Blanco-Fernández G. Surgical treatment of liver hydatid cyst in elderly patients: A propensity score-matching retrospective cohort study. Acta Trop 2022; 232:106466. [PMID: 35460646 DOI: 10.1016/j.actatropica.2022.106466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/16/2022] [Accepted: 04/11/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cystic echinococcosis is a clinically complex chronic parasitic disease and a major socioeconomic problem in endemic areas. The safety of liver resection in elderly patients is often debated among medical professionals. We analyzed the postoperative morbidity and mortality rates of elderly patients who underwent surgery at our unit. METHODS We retrospectively evaluated patients with liver hydatid cysts which were surgically removed at our unit. Patients were divided into two groups: Group 1 (patients < 70 years), and Group 2 (patients ≥ 70 years). Propensity score matching (PSM) and comparative analyses between groups were performed. RESULTS The unmatched cohort consisted of 279 patients (Group 1: 244; Group 2: 35). After PSM, we compared the outcomes for 56 patients from Group 1 to 31 patients from Group 2. A higher rate of severe complications was observed in Group 2 (25.8% vs 5.36%, p = 0.014). No difference was found in the rates of infectious, cardiorespiratory, or hemorrhagic complications between both groups, and in the mortality rate either (0.00% vs 6.45%, p = 0.124). CONCLUSIONS Liver surgery in selected elderly patients is safe and practicable. The low postoperative morbidity rate in these patients is acceptable, albeit higher, due to their comorbidities.
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Affiliation(s)
- Isabel Jaén-Torrejimeno
- Hospital Universitario de Badajoz. Servicio de Cirugía Hepatobiliopancreática y Trasplante Hepático. Avda. Elvas sn. 06080 Badajoz. España
| | - Diego López-Guerra
- Universidad de Extremadura. Facultad de Medicina y Ciencias de la Salud. Avda. de Elvas sn. 06006. Badajoz. España; Hospital Universitario de Badajoz. Servicio de Cirugía Hepatobiliopancreática y Trasplante Hepático. Avda. Elvas sn. 06080 Badajoz. España
| | - Adela Rojas-Holguín
- Universidad de Extremadura. Facultad de Medicina y Ciencias de la Salud. Avda. de Elvas sn. 06006. Badajoz. España; Hospital Universitario de Badajoz. Servicio de Cirugía Hepatobiliopancreática y Trasplante Hepático. Avda. Elvas sn. 06080 Badajoz. España
| | - Noelia De-Armas-Conde
- Hospital Universitario de Badajoz. Servicio de Cirugía Hepatobiliopancreática y Trasplante Hepático. Avda. Elvas sn. 06080 Badajoz. España
| | - Gerardo Blanco-Fernández
- Universidad de Extremadura. Facultad de Medicina y Ciencias de la Salud. Avda. de Elvas sn. 06006. Badajoz. España; Hospital Universitario de Badajoz. Servicio de Cirugía Hepatobiliopancreática y Trasplante Hepático. Avda. Elvas sn. 06080 Badajoz. España.
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Maimaitinijiati Y, Meng Y, Chen X. Is long-term follow-up without surgical treatment a valid option for hepatic alveolar echinococcosis? World J Gastroenterol 2022; 28:2775-2777. [PMID: 35979161 PMCID: PMC9260861 DOI: 10.3748/wjg.v28.i24.2775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/13/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
We read the article titled, “Long-term follow-up of liver alveolar echinococcosis using echinococcosis multilocularis ultrasound classification,” by Schuhbaur J with great interest. However, we found some worthwhile issues that we believe should be discussed with the authors, and have provided our comments in this letter. It would be valuable if the authors could provide further information about the clinical stages, follow-up time, and clinical outcomes of the patients.
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Affiliation(s)
- Yusufukadier Maimaitinijiati
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, Xinjiang Uyghur Autonomous Region, China
- School of Clinical Medicine, Medical College of Tsinghua University, Beijing 100084, China
| | - Yuan Meng
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, Xinjiang Uyghur Autonomous Region, China
| | - Xiong Chen
- Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, Xinjiang Uyghur Autonomous Region, China
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48
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Zhou LX, Xu XL, Yangdan CR, Wang HJ, Fan HN, Wang ZX. [Corrosive sclerosing cholangitis after surgical treatment of hepatic cystic echinococcosis: a case report]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2022; 34:552-555. [PMID: 36464249 DOI: 10.16250/j.32.1374.2021168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Corrosive sclerosing cholangitis is a rare postoperative complication of hepatic cystic echinococcosis. Although corrosive sclerosing cholangitis is rare, it progresses rapidly and lacks effective treatments, which usually results in a poor prognosis. This case report retrospectively analyzed the treatment and diagnosis of a case with corrosive sclerosing cholangitis following surgical treatment of hepatic cystic echinococcosis, so as to provide insights into the diagnosis and treatment of corrosive sclerosing cholangitis.
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Affiliation(s)
- L X Zhou
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, Qinghai 810001, China
| | - X L Xu
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, Qinghai 810001, China
| | - C R Yangdan
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, Qinghai 810001, China
| | - H J Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, Qinghai 810001, China
| | - H N Fan
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, Qinghai 810001, China
| | - Z X Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, Qinghai 810001, China
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A J, Zhang J, Chai J, Zhao S, Wang H, A X, Yang J. Comparison of the Efficacy of Anatomic and Non-anatomic Hepatectomy for Hepatic Alveolar Echinococcosis: Clinical Experience of 240 Cases in a Single Center. Front Public Health 2022; 9:816704. [PMID: 35211454 PMCID: PMC8863048 DOI: 10.3389/fpubh.2021.816704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/31/2021] [Indexed: 11/17/2022] Open
Abstract
Background Hepatic alveolar echinococcosis (AE) is a zoonotic parasitic disease. There are more than 16,000 new cases each year, approximately 60 million people are threatened, and the annual direct economic loss is RMB 3 billion. The prevalence of AE in some areas of the Qinghai–Tibet Plateau is as high as 6.0%. Radical resection, including anatomic and non-anatomic hepatectomy, for advanced AE can significantly prolong the survival time of patients. However, there is no literature compared the efficacy of anatomic and non-anatomic hepatectomy. Therefore, by comparing various clinical evaluation indices between anatomic and non-anatomic hepatectomy, this study explored the short-term and long-term efficacy of these two surgical methods for AE. Methods The clinical data of patients with AE who underwent radical hepatectomy at Qinghai Provincial People's Hospital from January 2015 to January 2021 were retrospectively analyzed. The patients were divided into two groups by surgical method, that were, non-anatomic hepatectomy group and anatomic hepatectomy group. We compared these two groups focusing on basic preoperative data, such as age, sex, lesion size, and liver function parameters; main intraoperative evaluation indices, such as operation time, intraoperative porta hepatis occlusion time, intraoperative blood loss, and blood transfusion; and postoperative recovery evaluation indicators, such as postoperative liver function, incidence of surgical complications, and AE recurrence. Results A total of 240 patients were enrolled in this study, including 123 in anatomic hepatectomy group and 117 in non-anatomic hepatectomy group. There were no significant differences (P > 0.05) between baseline characteristics. Anatomic hepatectomy group was advantageous than non-anatomic hepatectomy group regarding intraoperative blood loss (P < 0.001), blood transfusion (P < 0.001), and porta hepatis occlusion time (P < 0.001). There were statistically significant differences in postoperative liver function (aspartate aminotransferase: P < 0.001; alanine aminotransferase: P < 0.001), surgical complications (P < 0.001), and AE recurrence rate (P = 0.003). The median survival of patients in the anatomic hepatectomy group was 66 months, compared to 65 months in the non-anatomic hepatectomy group (χ2 = 4.662, P = 0.031). Conclusions Anatomic hepatectomy was not only safe for AE but also showed better short-term and long-term superiority than non-anatomic hepatectomy.
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Affiliation(s)
- Jide A
- Medical College of Soochow University, Suzhou, China
- Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining, China
| | - Jingni Zhang
- Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining, China
| | - Jinping Chai
- Department of Internal Medicine-Cardiovascular, Qinghai Provincial People's Hospital, Xining, China
| | - Shunyun Zhao
- Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining, China
| | - Hao Wang
- Intensive Care Unit, Qinghai Provincial People's Hospital, Xining, China
| | - Xiangren A
- Department of Clinical Laboratory, Qinghai Province Key Laboratory of Laboratory Medicine, Qinghai Clinical Medical Research Center, Qinghai Provincial People's Hospital, Xining, China
- Xiangren A
| | - Jinyu Yang
- Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining, China
- *Correspondence: Jinyu Yang
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Shaprinskiy V, Verba A, Formanchuk T, Formanchuk A, Chernychenko O. SURGICAL TREATMENT OF ECHINOCOCCOSIS OF THE LIVER AND ITS COMPLICATIONS. Wiad Lek 2022; 75:244-250. [PMID: 35182130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim: To analyze the frequency of complications of echinococcal cysts of the liver, the causes of recurrence and the results of surgical treatment of patients with echinococcal liver disease. PATIENTS AND METHODS Materials and methods: The results of surgical treatment of 79 patients who were hospitalized from January 2011 to JANUARY 2022 with liver echinococcosis and its complications were analyzed. Among them there were 11 men (13,9%) and 68 women (86,1%), with average age 47,5 ± 2,3 years. Complications of echinococcal cysts developed in 17 (21,5%) patients. RESULTS Results: The choice of surgical intervention method was determined individually, taking into account the location of echinococcal cysts, their size, depth, proximity of important anatomical structures. 53 (67,1%) patients underwent total or subtotal pericystectomy, 8 (10,1%) patients underwent liver segment resection, 5 (6,3%) patients underwent cyst dissection with removal and treatment its cavity, PAIR method was applied in 1 (1,3%) patient. Echinococcectomy was performed laparoscopically in 12 (15,2%) patients. The use of laparoscopic surgery for echinococcosis of the liver reduced intraoperative blood loss, duration of operation, hospital stay. We did not have recurrences of the disease after radical surgery. After palliative surgery, recurrence occurred in 2 (2,63%) patients. CONCLUSION Conclusions: Surgical interventions for urgent indications in patients with complicated echinococcal cysts of the liver increase the risk of recurrence of the disease. Pericystectomy was performed in 53 (67,1%) patients, is a radical and efficient operation for complete recovery and does not lead to recurrence of the disease. The efficiency of laparoscopic echinococcectomy has been demonstrated.
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Affiliation(s)
| | - Andriy Verba
- VINNYTSIA NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
| | - Tetiana Formanchuk
- VINNYTSIA NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
| | - Andrii Formanchuk
- VINNYTSIA NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
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